Recently, surgery using an endoscope (endoscopic surgery) is getting more widely performed. While the conventional surgery methods need to largely dissect the abdomen or chest of a human body for cutting, suturing or ligating the tissues to be treated, an endoscopic surgery only needs to cut a hole of a minimum size in the abdomen or other regions. Due to the smallness of the cut, early recovery of the patient is possible.
Endoscopic surgery is performed as follows. First, a trocar having a reverse stop valve is inserted into the hole cut in an abdomen. A gas is charged therethrough into the abdominal cavity to create a space at the surgery region. Thereafter, surgery is performed by inserting scalpels, forceps and the like in the abdominal cavity through the hollow space of the trocar. In order to monitor the surgery, another hole is created in the abdomen to insert another trocar to provide a monitoring camera therein for monitoring the operation of the surgery.
Since the space of the abdominal cavity is limited, surgeons must insert slender devices in a narrow space by monitoring the display to perform the surgery appropriately. Depending on the circumstances, surgeons must suture the tissue of the dissected portion or ligate a number of blood vessels.
The above suturing procedure is performed as follows. A guide device for guiding a needle having a suture, formed for example in a forceps shape, such as a guide device disclosed in Japanese Laid Open Patent Publication No. 9-56719, is inserted through the space in the trocar. Then, the tissues to be sutured are grasped and pierced by the needle having a suture. Thereafter, both ends of the piercing suture is pulled back outside the human body through the space of the trocar. Subsequently, a tie or knot (hereinafter referred to as a "knot") of the suture is formed outside the human body. This knot is then sent back to the place where the tissues are ligated by using a suture sending device called a "knot pusher", an example of which is disclosed in Japanese Laid Open Patent Publication No. 5-317321. Then, the tissues are ligated at that place. By repeating this operation more than two times, a ligation which will not get loose, such as called a "surgeon's knot", can be achieved.
However, at the time the knot is sent to the inner cavity with use of the knot pusher through the space of the trocar, the movement of the knot pusher is hindered by the reverse stop valves as well as the narrow space of the tube of the trocar, hitting many spots inside the trocar. Owing to this problem, the knot of the suture is sometimes separated from the knot pusher. If the knot has already passed the trocar and is reached the space of the abdominal cavity, it is still possible to recapture the knot by the knot pusher through monitoring the knot by the camera display. However, such an operation for recapturing the knot takes a long time. If the knot is separated from the knot pusher inside the trocar, it is extremely difficult to recapture the knot. Thus, the knot pressing operating has to start over again, taking a much longer time.
In addition, as described above, since the number of the knots to be tied for each tissue ligating is at least two, possibility of occurrence of the above trouble exists at least two times at one place. This results in a heavy burden to surgeons as well as patient. Further, the knot ligated by the first operation sometimes becomes loose before the second knot is sent thereto, resulting in the failure of sufficiently joining the tissues.